Snakebite Research Articles

Exploring the antisnake venom Potential of Zingiber officinale and its bioactive compounds against Naja nigricollis venom through computational approaches and experimental validation.

Snakebite envenomation remains a significant medical challenge, particularly in tropical and subtropical regions. The present study investigates the inhibitory potential of Zingiber officinale (ginger) and its bioactive compounds against Naja nigricollis venom using in silico approaches and animal models. No protection was observed in the in vivo studies but the extract of the plant was able to prolong the time of death with mean survival time ranging from 2.01 - 2.83 hours. In terms of the in vitro studies, the extract was able to significantly (p<0.05) detoxify the N. nigricollis venom by 80 % at the graded doses; standard antisnake venom (ASV) offered 100 % protection to mice. Molecular docking analysis revealed strong binding affinities between the bioactive compounds and the PLA2 enzyme, indicating potential inhibitory effects. The stability and dynamics of the protein-ligand complexes were further validated through molecular dynamics (MD) simulations, which confirmed the persistence of these interactions over time. In conclusion, the findings suggest that the bioactive compounds from Z. officinale could serve as promising inhibitors of PLA2, providing a foundation for the development of novel snakebite envenomation therapies.

Factors Associated with Complications of Snakebite Envenomation in Health Facilities in the Cascades Region of Burkina Faso from 2016 to 2021

Snakebite envenomation remains a major cause of morbidity and mortality in rural populations. This study identified factors associated with the complications of snakebite envenomation reported in the Cascades region of Burkina Faso. This cross-sectional study used the routine data of patients admitted for snakebite envenomation at five health facilities between 1 January 2016 and 31 December 2021. Data were collected on sociodemographic, clinical, and therapeutic characteristics of patients with signs of envenomation. Bivariate and multivariate analyses were conducted to identify factors associated with complications. Among the 846 patients with envenomation, 355 (42%) experienced complications. Local complications (23.2%, 196/846) included wounds and skin necrosis, whereas systemic complications (34.3%, 290/846) included hemorrhage, shock, and coma. Of all complicated cases, 7.6% (27/355) died. Factors associated with complications were rural residence (AOR: 4.80; 95% CI: 2.21–11.4), incision at the bite site (AOR: 4.31; 95% CI: 2.51–7.52), tourniquet application (AOR: 5.52; 95% CI: 1.42–30.8), bleeding (AOR: 14.2; 95% CI: 8.80–23.4), abnormal vital signs (AOR: 14.3; 95% CI: 9.22–22.7), and lack of antivenom administration (AOR: 2.92; 95% CI: 1.8–4.8). These findings highlight the importance of antivenom availability and public awareness for reducing the incidence of complications of snakebite envenomation.

A study of clinical profile and outcome of patients with snake bite-induced acute kidney injury

ABSTRACT Background: Snake bite is a well-known occupational hazard amongst farmers, plantation workers, and other outdoor workers and results in much morbidity and mortality throughout the world. The complications related to kidneys are observed in most patients with snake bites admitted to a hospital. The current study aimed to study the renal involvement in patients with snake bites with reference to clinical features and the time of onset of acute renal failure. Methods: A prospective clinical study of 68 patients of snake bite was done to know the clinical profile and outcome in Gandhi Hospital Secunderabad and cases were particularly looked for development of acute kidney injury. Later each case was studied and investigated with respect to onset, clinical features, course in the hospital, need for renal replacement therapy including dialysis, and mortality due to AKI. Patients were followed up till discharge or death. They were treated as per protocol. Results: The incidence of AKI was 29.1%. Common signs and symptoms were fang mark (100%), swelling (91.2%), tenderness (91.2%), bleeding manifestations (79.4%) oliguria (26.47%), anuria (5.8%), and haematuria (8.8%). Hypotension was present in 73%, which may be the cause of AKI. All the AKI patients showed coagulation abnormalities in the form of prolonged BT, CT, PT, and aPTT. Thrombocytopenia was seen in 29.4%. All the AKI patients were given ASV for 2 to 3 days. The mean ASV vials used in the present study is 15 ± 5. Hemodialysis was done in 29.4% of patients. Conclusion: The cause of AKI in snakebite was multifactorial in origin. Bleeding and hypotension were among the important causes. Thrombocytopenia was significantly related to clinical bleeding. The type of snakebite is an important factor in the development of AKI and Russell’s viper bite is more commonly associated with it. AKI is usually associated with oliguria and generally occurs within 48 hours.

The national action plan for prevention and control of snakebite envenoming in India (NAPSE): Its role, opportunities and challenges

The national action plan for prevention and control of snakebite envenoming in India (NAPSE): Its role, opportunities and challenges

Hyperglycosylation impairs the inhibitory activity of rCdtPLI2, the first recombinant beta-phospholipase A2 inhibitor

Crotoxin, a phospholipase A2 (PLA2) complex and the major Crotalus venom component, is responsible for the main symptoms described in crotalic snakebite envenomings and a key target for PLA2 inhibitors (PLIs). PLIs comprise the alpha, beta and gamma families, and, due to a lack of reports on beta-PLIs, this study aimed to heterologously express CdtPLI2 from Crotalus durissus terrificus venom gland to improve the knowledge of the neglected beta-PLI family. Thereby, recombinant CdtPLI2 (rCdtPLI2) was produced in the eukaryotic Pichia pastoris system to keep some native post-translational modifications. rCdtPLI2 (~41 kDa) presents both N- and O-linked glycans. Alpha-mannosidase digested-rCdtPLI2 (1 mol) strongly inhibited (73 %) CB-Cdc catalytic activity (5 mol), demonstrating that glycosylations performed by P. pastoris affect rCdtPLI2 action. Digested-rCdtPLI2 also inhibited PLA2s from diverse Brazilian snake venoms. Furthermore, rCdtPLI2 (1 mol) abolished the catalytic activity of Lmr-PLA2 (5 mol) and reduced the CTx-Cdc (5 mol) enzyme activity by 65 %, suppressing basic and acidic snake venom PLA2s. Additionally, crotalic antivenom did not recognize rCdtPLI2, suggesting a lack of neutralization by antivenom antibodies. These findings demonstrate that studying snake venom components may reveal interesting novel molecules to be studied in the snakebite treatment and help to understand these underexplored inhibitors.

A Comprehensive Examination of Common Poisoning and Snakebite Envenoming: Clinical Characteristics, Therapeutic Approaches, and Implications

A Comprehensive Examination of Common Poisoning and Snakebite Envenoming: Clinical Characteristics, Therapeutic Approaches, and Implications

Fabrication of Remotely Controllable Robotic Weed-Ejector Vehicle

Weed is an unwanted plant in an agriculture field that keeps the crop plants deprived of sunlight, fertilisers and water. If not removed, weed reduces the crop output to a larger extent i.e., endangering the farmer's interests. There are three main reasons for leaving weed to grow in fields and substantial loss of crop output 1) non-availability of agricultural labour, 2) fear of snake bites and 3) higher amounts of time required for weed injection. As of there are no successful ROVs (Remotely operating vehicles) to get to the weed and capable of pulling off the weed without the farmer physically entering into the agricultural fields. The Proposed model reduces farmers getting exposed to snake bites during weed ejection and reduces the time and labour requirement for weed ejection. The project involves the study of different mechanisms required for weed pull-off from the agricultural fields and remote-control systems, modelling of components, fabrication of components, assembly and testing of the Remotely Controllable Robotic Weed-Ejector Vehicle.

Clinical Profile of Snakebite: A Cross-sectional Study In A Upazila (Subdistrict) Health Complex, Bangladesh

Background:Snakebite remains a significant public health concern in many regions of Bangladesh, particularly in southern Chattogram. The Non communicable Disease Control (NCDC) program under DGHS has put tremendous efforts and motivation toward the healthcare provider at Upazilla level to treat cases of snakebite successfully. This study provides a comprehensive analysis of snakebite cases, focusing on the epidemiological patterns, clinical profiles and management observed at Lohagara Upazilla Health Complex. Method: Through a cross-sectional study, analysis of the records of past two years of admitted patients was done which elucidates the demographic characteristics, clinical presentations, and management outcomes of snakebite envenoming in the southern Chattogram community. Result: A total of 202 cases of snakebite were treated successfully, among which 63.9% were male (n=129) and 36.1% were female (n=73). The mean age was approximately 32 years (±17.40) and most were in the age group of 11-20 years (52, 25.74%). 26 (13%) cases developed local envenoming by green-pit viper bite, whereas 6 (2.9%) developed systemic envenoming with neurotoxicity alone and only 1 (0.5%) had features of both neurotoxicity and local swelling. The majority of cases had a short hospital stay, with 171 (84.7%) cases discharged after one day. Maximum patients (55.5%) reached the hospital within one hour of bite. In 53.46% of cases, the species of snakes could not be identified. Conclusion: These findings indicate the need for targeted public health interventions focusing on education and first-aid training, as well as improved pre-hospital care practices to better address snakebite incidents. J Bangladesh Coll Phys Surg 2024; 42: 305-311

Surge of snake bite in Bangladesh

Abstract not available J Dhaka Med Coll. 2023; 32(1) : 1-2

Epidemiological Aspects, Clinicopathology, Hemato-biochemistry and Therapeutic Management of Viperine Snake Envenomation in Buffaloes (Bubalus bubalis)

Background: Poisonous snakebite is a neglected tropical disease, frequently reported in animals including buffaloes. Snakebites are responsible for considerable morbidity and mortality in animals causing economic losses to dairy farmers. Methods: To establish the baseline data of epidemiology, clinical syndrome, hemato-biochemistry and diagnosis of viper snakebites and to standardize the treatment of viper snakebite in buffaloes. Result: The highest incidence of viper envenomation was observed during the monsoon and post-monsoon season in female buffaloes above 4 years of age. The clinical signs such as tachycardia, increased respiration rate, ascending swelling of affected limbs, asymmetrical swelling with dyspnea in case of bite over face and bleeding at the site of bite were observed in envenomed buffaloes. Hemato-biochemical analysis revealed neutrophilic leukocytosis, thrombocytopenia, prolonged capillary blood clotting time, elevated values of blood urea nitrogen (BUN) and creatinine. Post-mortem examination showed hemorrhages and blood-stained serous fluid in subcutaneous tissue and skeletal muscles of the affected limbs. The histopathological changes such as extensive myonecrosis and hemorrhages with marked edema in skeletal muscles, widespread interstitial and intra-alveolar hemorrhages and fibrinous microthrombi in pulmonary vasculature, multifocal to coalescing areas of massive hemorrhages and coagulative necrosis within hepatic parenchyma and marked degeneration of renal tubular epithelium were evident. Therapeutic regimen consisting of polyvalent anti-snake venom, with antibiotics, diuretics, vitamin B complex, styptics, fluids and corticosteroids in non-pregnant while non-steroidal anti-inflammatory drugs in pregnant buffaloes was used. The present treatment strategy showed subsidence of clinical signs, restoration of platelet count, blood clotting time, urea nitrogen and creatinine values depicting clinical recovery with 88.15% survival rate in treated buffaloes.

Specific anti-toxic immunotherapy: use in medical practice and perspectives

The results of use of approaches and means of antitoxic immunotherapy in medical practice are summarized: passive transfer of various variants of antibodies specific to toxic compounds, vaccination – specific active immunization with vaccines carrying determinants of the immunochemical specificity of target toxic compounds. The practical effectiveness of the known approaches of passive transfer and vaccination is associated with the ability of specific antibodies, by binding target bioactive compounds with pronounced toxicity, to change the availability of corresponding structures in the body-targets and, in the presence of a sufficient number of specific antibodies with high binding ability to the target compounds, neutralize their toxicity. In medical practice, polyspecific heterologous antisera or the gamma globulin fraction of antisera (extremely rare monoclonal antibodies of narrow specificity) are widely used for passive transfer as antidotes in the treatment of victims in order to prevent deaths and extensive necrosis of soft tissues at the site of the bite of poisonous snakes and insects. Active immunization – vaccination with appropriate antigenic drugs should create in immunized individuals a state of humoral immunity with the corresponding characteristics of antibody formation specific to the target compound. When a target toxic compound enters an immunized organism, it is also possible to neutralize its toxicity. The most successful experience in using the principles of active immunization as a technology for specific antitoxic therapy is associated with the practice of using toxoids for toxinemic infections. Specific practical techniques used to achieve the effectiveness of possible approaches to specific antitoxic immunotherapy in the form of passive transfer of specific antibodies or their fragments are considered: to combat lethal infections in the pathogenesis of which the toxic effects of bacterial exotoxins are significant; when treating victims of snake and insect bites, exposure to poisons of marine organisms, algae and plant toxins; in the treatment of severe intoxication with certain low molecular weight toxic substances: digoxin, colchicine, tricyclic antidepressants. The most successful experiences of using the principles of active immunization as a technology for specific antitoxic therapy, based on the use of toxoids with specificity for diphtheria, tetanus, botulism, cholera, typhoid fever, dysentery, gas gangrene and other toxinemic infections, are also considered. The fairly high immunogenicity of toxoids with the possibility of activating both constitutional and adaptive immunity has become the basis for their use as macromolecular carriers of hapten analogues of narcotic substances – a promising direction in drug addiction, in the implementation of which a number of experimental molecular and combined vaccines of opiates, methamphetamine, cocaine, and nicotine. This variant of practical efforts in medicine can be regarded as a new direction of specific antitoxic immunotherapy – an option to combat drug addiction by vaccinating drug addicts.

Superior Mesenteric Artery Syndrome in Patients with Snake Bites

Superior Mesenteric Artery Syndrome in Patients with Snake Bites

A Case of Snake Bite in a One-Year-Old Cross-Breed Cow – A Case Report

This clinical article reports a case of snake bite in a -year-old Friesian and white Fulani cross-breed cow at the Livestock Investigation Division of the National Veterinary Research Institute, Vom, Nigeria. The clinical signs observed during the physical examination are as follows: swollen brisket region and left forelimbs, anorexia, fever (39.2°C), and difficulty walking. The whole blood clotting time was positive (Absence of clotting for more than 2 h). The affected cow was treated using antibiotics, diuretics, and anti-inflammatory agents without the administration of anti-venom. The recovery was uneventful within 3 days following treatment.

Early intervention in viper bites: A potential strategy to mitigate acute kidney injury and its long-term consequences.

Dear Editor, By this letter we intend to highlight the close association between snake bites and acute kidney injury, as the causative snakes are common natives of Tropical regions and a common cause of death because of being poorly managed. Snake bites are a significant cause of acute kidney injury in tropical regions, particularly in Eastern Pakistan, where Russell's viper, a common cause, is prevalent. The farmlands of Sindh and Balochistan are predisposed to snake bites due to their favorable weather and vast fields. A 2020 study found 454 snakebite cases in Southern Sindh, with 6 deaths. The most common mechanisms are venom-mediated consumption coagulopathy (VMCC) and endothelial damage, leading to systemic bleeding diathesis and decreased perfusion of end organs. Long-term effects of snake bites include worsening renal conditions and progression towards end-stage renal disease. Eastern Pakistan commonly harbors Russell’s viper- a frequent cause of snakebite-associated mortality, which belongs to the Viperidae family and is famously known to produce vasculotoxic venom. (1) The farmlands of Sindh and Balochistan are predisposed to snake bites as the weather of these regions and the vast fields allow the vipers to flourish and thrive well. A study conducted in 2020, representing the population of Southern Sindh, demonstrated a total of 454 cases of snakebite in a span of 1 year, out of which 6 victims died. (2) Since the prevalence of vipers is common in the district of Sindh, the deaths could be attributable to the hemorrhagic manifestations of vipers' bites. The most significant mechanisms underlying viper bite presentations are venom-mediated consumption coagulopathy (VMCC) and endothelial damage resulting in systemic bleeding diathesis, which together contribute to decreased perfusion of end organs like the heart, kidneys, brain, or gastrointestinal system. (3) VMCC is a major contributor to acute kidney injury (AKI), a common outcome of vasculotoxic snake bites, along with enzymatic dissolution of the glomerular basement membrane (BM) by the venom metalloproteinases. (4) The hemorrhagic deterioration of the vessels leads to ischemic nephropathy, and the impaired BM allows proteinuria, hemoglobinuria, and increased creatinine, often predisposing the victim to timely dialysis. A study concluded that individuals with co-morbidities are more susceptible to developing long-term effects of snake bites like worsening renal conditions such as new-onset hypertension, dialysis dependence, and end-stage renal disease. (5) ---Continue

Protective effect of Tecoma stans (L.) Juss.ex Kunth in CFA-induced arthritic rats

Ethnopharmacological relevanceTecoma stans (L.) Juss.ex Kunth (Bignoniaceae) is mainly found in tropical and subtropical regions of Africa and Asia. The leaves, flowers, roots, and bark are used to treat various aliments includes, skin infections, kidney problems, intestinal disorders, jaundice, toothaches, joint pain and repair cracked bones, antidotes for snake, scorpion, and rat bites. Aim of the studyThe objective of the study is to assess the anti-arthritic properties of T. stans leaf using Complete Freund's adjuvant (CFA)-induced rat. Materials and methodThe ethanol extract of T. stans leaf (ETSL) was subjected toGas Chromatography-Mass Spectrometry (GC-MS) and Liquid Chromatography-Mass Spectrometry (LC-MS) analysis for the identification of potential bioactive. The anti-arthritic activity was carried out by administering CFA (0.1 ml) into the sub-plantar surface of the right hind paw. The experimental animals were treated with indomethacin (10 mg/kg) and ETSL (250, 500 mg/kg) once a day orally for fourteen days. The arthritic parameters and hematological and biochemical parameters were evaluated using standard kit reagents. The levels of pro-inflammatory cytokines and inflammatory mediators were measured in blood serum. Antioxidant parameters were assessed in homogenized liver and joint tissues. Radiological and histopathological analysis of joint was performed. A computational molecular docking investigation of the phytoconstituents was conducted against COX-2, IL-1β, IL-6, and TNF-α receptors. ResultsThe ETSL at 500 mg/kg demonstrated significant (p < 0.01) restoration of arthritic parameters, hematological and biochemical indices and oxidative stress in CFA-induced rats which was further supported by radiological histological examination. In addition, there was significant (p < 0.05) reduction observed in pro-inflammatory cytokines, inflammatory mediators and up-regulation of anti-inflammatory cytokines in the treated group. Verbascoside was found to exhibit better biding affinities −10.4, −7.4, −7 and −6.2 kcal/mol against COX-2, IL-1β, TNF-α, and IL-6 respectively, confirmed through in silico study. ConclusionsThe observed outcome suggests that ETSL at a dosage of 500 mg/kg demonstrated notable anti-arthritic effects by suppressing pro-inflammatory cytokines and oxidative stress biomarkers. This effect could potentially be attributed to the presence of bioactive verbascoside identified in the LC-MS analysis.

Role of Plant-derived Bioactive Compounds in Potential Snakebite Envenoming: A Review

: The issue of snakebite continues to be a distinctive matter of public health in various regions across the globe, with a particular emphasis on India, where the ailment is widely prevalent. Snakebites in the country disproportionately affect rural and indigenous populations, resulting in some of the highest morbidity and mortality rates worldwide. Regrettably, in numerous tropical nations, the accessibility of antivenom is frequently postponed or restricted, thereby rendering antiserum the only targeted therapeutic alternative. Nevertheless, administering antiserum in isolation does not provide adequate safeguard against the adverse effects of venomtriggered hypersensitivity complications, which may be grave. Hence, this study aims to review the plant-derived bioactive compounds used to treat snakebites in India. This review compiles a list of medicinal plants and plant-derived bioactive compounds used in treating snakebites in India, which were reviewed from the available literature in public databases (PubMed, Science Direct, Springer, and Scopus). Search words used were 'bioactive compounds,' 'treatment for a snakebite,' 'antivenom and snakebite,' 'Medicinal plants for snakebite, and 'composition of snake venom'. : A list of 200 medicinal plants traditionally used in several countries for treating snake bites was obtained. Based on scientific data, we reviewed only 83 medicinal plant extracts and bioactive compounds obtained from various families, tested under in-vivo and in-vitro conditions to determine their neutralization potency of snakebite envenomation. In this article, we have presented a comprehensive review, judgmentally analyzed medicinal plants and their bioactive compounds for their therapeutic potential against snake envenomation, and offer a thorough discourse on diverse herbal plants employed globally for managing snakebites.

Acute Ischemic Stroke After Russell’s Viper Snake Bite, Rare Presentation: A Case Report

Snake bitesare a global health hazard and are a noteworthy cause of mortality and morbidity especially in Southeast Asia. Cerebral complicationsafter snake bite are rare. It can be attributed to various factors such as vasculitis, vasospasm, endothelial damage; toxin-induced procoagulant effect, and disseminated intravascular coagulation. We present a case of a previously healthy 22-year-old woman who suffered acute multiple cerebral infarctions following Russell's viper bite. Imaging revealed significant non-hemorrhagic infarctions in the left middle cerebral artery territory and right pons, indicating rare yet severe neurological complications of viper envenomation. The patient experienced serious complications including rhabdomyolysis and acute kidney injury, ultimately leading to her demise due to aspiration pneumonia and septic shock. This case underscores the potential neurological impact of viper envenomation and underscores the challenges in managing delayed procoagulant effects of snake venom, despite the administration of anti-snake venom. Early detection and intervention remain vital in addressing such devastating outcomes.

ACIDENTE OFÍDICO: REVISÃO DE LITERATURA

Snakebite envenomation refers to the injection of venom through the fangs of snakes. In tropical countries like Brazil, there is a high incidence of snakebite cases in both humans and animals, making it a public health and economic issue, particularly in cattle farming. There are various species of snakes, with 76 being toxin producers. The effects caused by these toxins can vary, and the diagnosis is based on clinical history, physical examination, and characteristic clinical signs. Initial medical support should be provided as soon as possible to avoid secondary complications and death. Based on extensive literature review, therapeutic approaches in these situations should be adapted to each circumstance and patient need. Effective management is essential to ensure the good recovery of the affected animal.

Is the acute compartment syndrome diagnosed in snake bites true?: A review.

Envenomation caused by venomous snakes can induce clinical symptoms and signs resembling those of traumatic acute compartment syndrome (ACS), but it is uncertain whether its treatment guidelines are applicable or beneficial for ACS that is associated to snakebites. Nonetheless, recommendations for the diagnosis and treatment of trauma-induced ACS, particularly following fractures of the tibial diaphysis, are extrapolated to the diagnosis and treatment of snakebites despite evidence that the ensuing injuries are frequently not true ACS. Most biologists agree that the venom of snakes, especially those of the Crotalinae family (vipers) evolved to immobilize, kill, and initiate the digestion of their prey. The human local effects of viper envenoming are the result of digestion like those described in biological processes as acute pancreatitis, including secondary inflammatory and induction of reparative effects. The first-line treatment should focus on mitigation of venom-induced tissue digestion rather than surgery solution for "ACS-like" symptoms and signs. This type of analysis leads to questioning that treatment of ACS associated with snakebite cannot be extrapolated from recommendations formulated for trauma-induced ACS. The cornerstone of snake envenoming treatment is antivenom, and some clinical and experimental experiences start to show that surgical procedures frequently employed for trauma-induced ACS, such as debridement and fasciotomy, may be exaggerated and even deleterious in most viper bite envenoming.

Treatment response and clinical features of snakebite envenomation in Alborz province, Iran: A cross-sectional study.

Snakebite envenomation is a significant yet neglected public health burden. Our aim was to investigate the clinical and demographic factors of snakebite envenomation, as well as the factors associated with its severity and response to treatment, in Alborz province, northern Iran. In this cross-sectional study, we included 50 patients diagnosed with snakebite envenomation, referring to the Poison Control Centre of Alborz University of Medical Sciences. The presenting signs and symptoms, demographic data, treatment dose, response to treatment, complications, laboratory findings, and snakebite severity scale (SSS) were collected. Forty-six patients (92%) were men, the total mean age was 31.7 ± 12.06 years, and mean SSS was 6.54 ± 3.39. The patients were admitted for a median of 2 days, and 11 patients needed ICU admissions. The majority of snakebites were in upper extremities (60%) and they mainly occurred in summer (56%). SSS was significantly associated with response to treatment, ICU admission, gastrointestinal adverse events, thrombocytopenia, and length of stay. Similarly, response to treatment was significantly related to the history of snakebite, ICU admission, gastrointestinal adverse events, thrombocytopenia, length of stay, and SSS. Gastrointestinal symptoms, higher severity scores, and longer hospital stays were associated with poor treatment response. Importantly, no mortality was observed in this cohort. Further research is needed to confirm these findings and optimize treatment strategies for snakebite management.